Sažetak
Uvod. Primarni adrenalni nehočkinski limfom izuzetno je redak oblik limfoma i odlikuje se lošom prognozom. Sa druge strane, double-hit limfomi sa BCL2 i MYC translokacijom karakterišu se uznapredovalom bolešću u vreme postavljanja dijagnoze, često prisutnom ekstranodalnom lokalizacijom bolesti i lošom prognozom. Prikaz bolesnika. Prikazali smo bolesnika starog 73 godine sa double-hit primarnim limfomom nadbubrega sa očuvanom adrenalnom funkcijom i povoljnim kliničkim tokom. Kompjuterizovanom tomografijom abdomena registrovana je tumorska promena leve adrenalne žlezde, veličine 9 ´ 7 cm, dok nije utvrđeno prisustvo bolesti na drugim lokalizacijama. Učinjeno je kompletno hirurško ukljanjanje tumorske promene i na osnovu histološkog pregleda postavljena je dijagnoza difuznog B krupnoćelijskog limfoma, (DLBCL) non-GCB podtipa. Nakon hirurškog lečenja primenjen je R-CHOP protokol sa redukovanim dozama adriablastina zbog smanjene ejekcione frakcije leve komore. I pored veoma lošeg prognostičkog profila bolesti (non-GCB tip, bulky bolesti, visokih vrednosti laktat dehidrogenaze, visokog komorbiditetnog skora i double-hit fenotipa) bolesnik je već 20 meseci u kompletnoj remisiji. Conclusion. Imunohemioterapija (R-CHOP) u kombinaciji sa hirurškim lečenjem je efikasna prva linija terapije kod bolesnika sa primarnim adrenalnim difuznim B-krupnoćelijskim limfomom i pored nepovoljnog prognostičkog profila i double-hit fenotipa bolesti.
Ključne reči
non-hodkin||
||limfom
nehodžkinov
adrenal gland neoplasms||
||nadbubrežne žlezde
neoplazme
drug therapy||
||lečenje lekovima
surgical procedures
operative||
||hirurgija
operativne procedure
prognosis||
||prognoza
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